Although the prognosis for patients with systemic lupus erythematosus has improved over the past few decades, it is still a disease that is associated with substantial morbidity and mortality. As a consequence of the disease itself or medications used to treat it, patients accrue irreversible organ damage over time. The identification of medications that not only treat lupus activity but also prevent damage accrual (rather than contributing to it) is of critical importance. Recent evidence suggests that hydroxychloroquine may be such a medication. Little is known about the potential protective effect of other medications used to treat lupus. As part of a mentored patient- oriented research career development award, the candidate will pursue formal training in study design, epidemiology and outcomes research, preparing for a career as an independent clinic researcher. She will perform a study investigating the impact of medications on the accrual of organ damage in patients with systemic lupus erythematosus. The specific aims of the study are: 1) To conduct a medical records abstraction on lupus patients participating in a longitudinal study of outcomes (LUMINA) in order to gather specific information about the dose and duration of pharmacologic therapies to augment the existing database, 2) To combine the LUMINA database with data from other longitudinal lupus cohorts from Johns Hopkins, Northwestern University and the University of Puerto Rico to increase the power of the study to evaluate the relationship between medication use and organ specific damage and 3) To analyze the potential impact of medications on the accrual of damage using propensity score analyses to control for confounding variables. The combined database will consist of longitudinal data on more than 2,200 well characterized lupus patients and will serve as a valuable resource for future studies. The identification of medications that lower the risk of organ damage would help to improve long-term outcomes in lupus patients.